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Radin S, El-Bassyouni G, Vresilovic EJ, Schepers E, Ducheyne P. In vivo tissue response to resorbable silica xerogels as controlled-release materials. Biomaterials 2005; 26:1043-52. [PMID: 15369693 DOI: 10.1016/j.biomaterials.2004.04.004] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2003] [Accepted: 04/06/2004] [Indexed: 11/15/2022]
Abstract
Biodegradable, controlled-release carrier materials with non-toxic degradation products are valuable for local delivery of biologically active molecules. Previously, it was shown that room-temperature processed silica sol-gels (or xerogels) are porous, resorbable materials that can release molecules of various sizes in a controlled, time dependent manner. Previous in vitro studies also demonstrated benefits of silica xerogels as controlled-release materials for the treatment of bone infections. Herein the tissue and cell response to xerogels is documented using a subacute implantation procedure. The tissue response was correlated to composition, surface properties, resorption rate and incorporation of the antibiotic vancomycin. Ca- and P-free and Ca- and P-containing xerogels, with and without apatite (AP) surface, were used. Xerogels were implanted either as discs in a subcutaneous site, or as granules in the iliac crest of New Zealand white rabbits. The samples with surrounding tissue were retrieved after 2 and 4 weeks of implantation. Silica xerogels implanted either as discs subcutaneously or as granules in the iliac crest showed a favorable tissue response. The granules, either with or without Ca and P content, gradually resorbed over time. The resorption was accompanied by extensive trabecular bone growth and a minimal inflammatory response. Ca- and P-containing granules with an AP-surface layer showed a slower resorption rate and more extensive new bone growth than those without AP layer. Among AP-coated granules, those with incorporated vancomycin showed the most favorable tissue response. The present in vivo data together with prior in vitro data suggest that these xerogels have potential as controlled-release materials for the treatment of bone infections and as carrier materials for a variety of other applications.
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130 |
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Friberg O, Svedjeholm R, Söderquist B, Granfeldt H, Vikerfors T, Källman J. Local Gentamicin Reduces Sternal Wound Infections After Cardiac Surgery: A Randomized Controlled Trial. Ann Thorac Surg 2005; 79:153-61; discussion 161-2. [PMID: 15620935 DOI: 10.1016/j.athoracsur.2004.06.043] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2004] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sternal wound infections remain a major cause of morbidity after cardiac surgery. Vancomycin is often the only effective antibiotic available for their treatment but its use for routine prophylaxis is inadvisable for ecological reasons. Local application of gentamicin produces high antibiotic concentrations in the wound. We aimed to determine whether this treatment could have an additive effect on the incidence of sternal wound infections when combined with routine prophylaxis. METHODS Two thousand cardiac surgery patients were randomized to routine prophylaxis with intravenous isoxazolyl-penicillin alone (control group) or to this prophylaxis combined with application of collagen-gentamicin (260 mg gentamicin) sponges within the sternotomy before wound closure. Endpoint was any sternal wound infection within 2 months postoperatively. Evaluations were double-blind and made on an intention-to-treat basis. RESULTS Evaluation was possible in 967 and 983 patients in the control and treatment groups, respectively. The incidence of sternal wound infection was 4.3% in the treatment group and 9.0% in the control group (relative risk 0.47; 95% confidence interval 0.33-0.68; p < 0.001). Early reoperation for bleeding was more common in the treatment group (4.0% vs 2.3%, p = 0.03). No difference in postoperative renal function was noted. CONCLUSIONS Local collagen-gentamicin reduced the risk for postoperative sternal wound infections. Further studies are warranted to confirm these results, particularly with regard to deep infections.
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Torres-Lagares D, Gutierrez-Perez JL, Infante-Cossio P, Garcia-Calderon M, Romero-Ruiz MM, Serrera-Figallo MA. Randomized, double-blind study on effectiveness of intra-alveolar chlorhexidine gel in reducing the incidence of alveolar osteitis in mandibular third molar surgery. Int J Oral Maxillofac Surg 2006; 35:348-51. [PMID: 16289676 DOI: 10.1016/j.ijom.2005.08.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Revised: 07/26/2005] [Accepted: 08/03/2005] [Indexed: 11/30/2022]
Abstract
Chlorhexidine (CHX) mouthwash is a good prophylactic agent for postextraction alveolar osteitis (AO), a very common complication. Recently, a bio-adhesive gel to deliver the active substance, CHX, has been introduced. The intra-alveolar positioning of the bio-adhesive gel allows more direct and prolonged action of CHX, which could be useful in the prevention of AO following extraction of impacted third molars. Presented here is a double-blind, randomised and parallel-group study evaluating the efficacy of the bio-adhesive 0.2% CHX gel (n=53) applied once within the alveolus during third molar surgery, compared to placebo gel only (n=50), in reducing the incidence of impacted third-molar postextraction AO. A 63.33% reduction in the occurrence of AO (P=0.019) was observed in the experimental group. In the control group, the occurrence of AO was 30% compared to 11% in the experimental group. Bio-adhesive 0.2% CHX gel, applied only once within the alveolus site at the time of surgery, may reduce the incidence of AO following removal of impacted third molars.
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Wettstein R, Erni D, Berdat P, Rothenfluh D, Banic A. Radical sternectomy and primary musculocutaneous flap reconstruction to control sternal osteitis. J Thorac Cardiovasc Surg 2002; 123:1185-90. [PMID: 12063467 DOI: 10.1067/mtc.2002.121304] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Sternal osteitis after median sternotomy is associated with considerable morbidity and mortality. The use of muscle and omentum flaps has been proved as valid adjunct to combat these severe infections. In this study we present our experience with a more radical approach. METHODS Sternectomy consisted of the resection of the entire sternum, including the costochondral arches and the sternoclavicular joints, and was followed by the repair of the defect with musculocutaneous flaps without any restabilization of the thoracic wall. Thirteen patients received a vertical rectus abdominis musculocutaneous flap, 14 patients received a pedicled latissimus dorsi musculocutaneous flap, and 12 patients received a free latissimus dorsi musculocutaneous flap (total of 40 flaps in 39 patients of 66 patients who required surgical revision for sternal osteitis of 6078 total patients with sternotomies). RESULTS Two patients died within 30 days after the operation (early mortality of 5.1%); however, they did not die of sternal infection, which was cured without any recurrence in all cases. Seventeen patients (44%) required secondary, mostly minor operations for local complications. Despite some paradoxic chest movements, the patient satisfaction rating was unanimously high at the long-term follow-up (0.4 to 8.5 years, median 2.3 years). The short- and long-term complication rates were similar in the three groups. CONCLUSION We conclude that radical sternectomy and immediate musculocutaneous flap repair provided definitive control of sternal infection in even the most severe cases, thus reducing infection-related mortality. The trade-off was a substantial rate of local complications; however, these did not cause any relevant morbidity.
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Kalteis T, Lehn N, Schröder HJ, Schubert T, Zysk S, Handel M, Grifka J. Contaminant seeding in bone by different irrigation methods: an experimental study. J Orthop Trauma 2005; 19:591-6. [PMID: 16247302 DOI: 10.1097/01.bot.0000174032.91936.4a] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study was designed to investigate the effectiveness of using various devices and manual procedures for cleansing bacterially contaminated bone tissue and to assess the risk of iatrogenic bacterial seeding in deep bone layers. METHODS In an in vitro model, human femoral heads were contaminated with Escherichia coli and then cleansed with pulsatile high-pressure lavage, pulsatile low-pressure lavage, manual rinsing with bulb syringe lavage, or manual rinsing with combined brush cleaning. The numbers of bacteria that remained or those that were introduced by the rinsing procedures were quantitatively determined at depths of 0 to 1 cm, 1 to 2 cm, and 2 to 3 cm. RESULTS Both pulsatile high-pressure lavage and brush cleaning were more effective than pulsatile low-pressure lavage and bulb syringe lavage for the purpose of surface cleansing. The differences were highly significant (P < 0.001). There was no significant difference in the decontaminating effect between pulsatile high-pressure lavage and brush cleaning (P = 0.24). The bacterial contamination attributable to the cleansing procedure, as measured at tissue depths of 1 to 2 cm and 2 to 3 cm, was significantly higher after pulsatile high-pressure lavage and after pulsatile low-pressure lavage than it was after bulb syringe lavage or brush cleaning (P < 0.001). CONCLUSION In this in vitro investigation of cancellous bone, the brush cleansing was just as effective for getting rid of bacterial contamination as pulsatile high-pressure lavage, and carries a significantly lesser risk of iatrogenic bacterial seeding into deeper tissue layers. In the light of these promising results obtained by the cleansing of cancellous bone contaminated with bacteria, it would be desirable to perform supplementary in vitro and in vivo investigations into brush cleansing.
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Comparative Study |
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Frederick RW, Carey JM, Leach GE. Osseous complications after transvaginal bone anchor fixation in female pelvic reconstructive surgery: Report from single largest prospective series and literature review. Urology 2004; 64:669-74. [PMID: 15491696 DOI: 10.1016/j.urology.2004.04.051] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2004] [Revised: 04/23/2004] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To report, from our prospective database and review of published studies (including primary reported patient series and case reports for osseous complications after transvaginal bone anchor fixation in female pelvic reconstructive surgery), our results and those from previously reported patient series to determine the incidence of osteitis pubis and osteomyelitis. METHODS A total of 440 patients from our database of cadaveric transvaginal sling (n = 127) and cadaveric prolapse repair with sling (n = 313) procedures had at least 3 months of examination follow-up and were included in this report. We found 15 primary reported patient series involving transvaginal bone anchor fixation in published studies, for a total of 788 patients. The combined patient population of 1228 was assessed for the incidence of osteitis pubis and osteomyelitis. RESULTS Of our 440 patients included in this study, 2 developed osteitis pubis (0.45%), and none had osteomyelitis (0%). In the published studies we reviewed, no case of osteitis pubis and 1 case of osteomyelitis (1 of 788, 0.13%) were reported. One additional case of osteomyelitis with transvaginal bone anchor fixation was reported. The combined incidence of osteitis pubis was 2 (0.16%) of 1228, and the combined incidence of osteomyelitis was 1 (0.08%) of 1228. CONCLUSIONS In procedures using transvaginal bone anchor fixation in female pelvic reconstructive surgery, the combined incidence, from our experience and that reported in published studies, of osteitis pubis and osteomyelitis was 2 (0.16%) and 1 (0.08%) of 1228, respectively. The infectious osseous complication rate associated with transvaginal pubic bone anchor fixation appears to be less than that previously reported for suprapubic bone anchor placement. In our experience, when using careful surgical technique and proper prophylactic precautions, infectious osseous complications have not been encountered.
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Petri WH, Wilson TM. Clinical evaluation of antibiotic-supplemented bone allograft. J Oral Maxillofac Surg 1993; 51:982-5; discussion 986. [PMID: 8355104 DOI: 10.1016/s0278-2391(10)80039-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Antibiotic-supplemented bone allograft (ASBA) was originally developed for treatment of combat-acquired, avulsive defects of the oral and maxillofacial skeleton. Earlier findings in experimental wound models showed that ASBA resulted in significantly improved wound repair of infected osseous defects when compared with conventional treatment. In this study, ASBA was evaluated in paired, comparable, mandibular third molar sockets and compared with the findings following conventional surgical removal. The results of this assessment showed that wound healing was significantly improved with the use of ASBA. Evidence produced by this clinical evaluation of ASBA suggests its potential use for other surgical bone defects when grafting is precluded by the risk of infection as a result of contamination by oral flora.
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Clinical Trial |
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Bystedt H, Dahlbäck A, Nord CE. Concentration of azidocillin, erythromycin, doxycycline and clindamycin in dental alveolar serum after single oral doses. INTERNATIONAL JOURNAL OF ORAL SURGERY 1977; 6:65-74. [PMID: 405337 DOI: 10.1016/s0300-9785(77)80001-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Treatment of osteitis in the mandible after surgery is still a clinical problem. Levels of four antibiotics--azidocillin, erythromycin, doxycycline, and clindamycin--were measured in serum and dental alveolar serum in 42 patients undergoing oral surgery. The systemic serum concentrations were higher than the dental alveolar serum concentrations in all patients. The maximal concentration in the alveolar serum for azidocillin was 6.0-12.0 microng/ml, for erythromycin 0.7-1.3 microng/ml, for doxycycline 2.8-3.6 microng/ml, and for clindamycin 2.0-2.8 microng/ml. When the dental alveolar serum concentrations of the various antibiotics were related to their range of inhibitory concentrations for microorganisms isolated from mandibular osteitis, it was noticed that each drug achieved levels sufficient to inhibit most strains.
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Abstract
Biodegradable polymers are gaining acceptance as alternative materials to metallic devices in fracture fixation applications. Self-reinforced polyglycolide and polylactide fixation devices have been used effectively in managing several thousand clinical cases involving small-fragment fractures. An eight percent incidence of non-specific inflammatory reaction and insufficient mechanical strength to deal with load-bearing situations are the two issues preventing the widespread acceptance of these biodegradable fixation devices. This brief review examines the potential of other biodegradable polymers, discusses the biodegradable composite design, and considers future research directions that might realize the full potential of biodegradable polymeric prostheses.
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Review |
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Gabbiani G, Tuchweber B, Côté G, Lefort P. Action of thyroxine and calcitonin on experimental soft-tissue calcification. CALCIFIED TISSUE RESEARCH 1968; 2:30-7. [PMID: 5674913 DOI: 10.1007/bf02279191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Räihä J, Granholm S, Rinkinen M, Miettinen S, Törmälä P. Effect of slow release antibiotics on pin-tract infection. TIJDSCHRIFT VOOR DIERGENEESKUNDE 1993; 118 Suppl 1:18S. [PMID: 8480307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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13
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Rodeheaver GT, Rukstalis D, Bono M, Bellamy W. A new model of bone infection used to evaluate the efficacy of antibiotic-impregnated polymethylmethacrylate cement. Clin Orthop Relat Res 1983:303-11. [PMID: 6883865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An animal model of bone infection was designed for evaluation of the benefits of adding antibiotics to polymethylmethacrylate (PMMA) cement. Femora of New Zealand albino rabbits were exposed at the knee; the medullary canals were entered and the contents aspirated. A known number of bacteria was added to each femur before it was filled with either normal Surgical Simplex P bone cement or Surgical Simplex P antibiotic bone cement. The presence or absence of bone infection was documented by quantitative bacteriologic, roentgenographic, and histologic techniques. Simplex antibiotic bone cement prevented infection, even in the presence of 10(7) bacteria. The effectiveness of the antibiotic bone cement was correlated with the rapid release of high levels of erythromycin (14.1 micrograms/g) and colistin (11.3 micrograms/g) specifically at the site of bacterial contamination.
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Rubinacci A, Cuccurullo G. [Skeletal lesions caused by gunshot wounds: analysis of the damage as related to to the risk of infection]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1980; 66:505-10. [PMID: 7318565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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15
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Müller W. [Frequency and prevention of osteitis of the fracture line in the era of antibiotics]. STOMA 1968; 21:110-7. [PMID: 5243596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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16
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Bołtuć W, Kotela I. [Management of multiple open fractures of long bones in multiple trauma]. PRZEGLAD LEKARSKI 2006; 63 Suppl 7:29-31. [PMID: 17806191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Management of multiple injuries is presented in the following article. 14 patients with open fractures during multiple trauma were assessed taking into consideration: time of post trauma stabilization and such complications as osteitis and growth impairment. Patients' clinical status with specific aspects were assessed (stride, muscle atrophy, edema, limaxis). Infected tibia false joints were diagnosed in 3 patients. 2 cases concerned open fractures of the II degree and III degree degree of the tibia according to Gustilo. They were patients operated during the first 24 houre in the year 2000. No such complications as infected false joints were diagnosed in patients operated between the 8th-10th day post trauma. All patients achieved bone growth and normal waound post traumatic bone healing.
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English Abstract |
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Sando B. Challenges in sports medicine. J Sci Med Sport 2003; 6:247-59. [PMID: 14609141 DOI: 10.1016/s1440-2440(03)80018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Baker LR, Muir JW, Sharman VL, Abrams SM, Greenwood RN, Cattell WR, Goodwin FJ, Marsh FP, Adami S, Hately W. Controlled trial of calcitriol in hemodialysis patients. Clin Nephrol 1986; 26:185-91. [PMID: 3536232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We report on a 5-year, prospective, double-blind trial of 1,25 dihydroxycholecalciferol (calcitriol) versus placebo in 76 hemodialysis patients without biochemical or radiological evidence of bone disease. Calcitriol, 1 microgram daily, regularly induced hypercalcemia. Doses of 0.25 microgram daily or less proved satisfactory in most patients. During calcitriol treatment, plasma calcium concentration was significantly higher and serum parathyroid hormone concentration significantly lower than on placebo. There was no difference in the rates of development or of progression of vascular calcification in the two groups. Significantly more patients on placebo (17 vs. 6, p less than 0.05) developed a sustained elevation of plasma alkaline phosphatase concentration. Calcitriol appeared to protect against the development of histological evidence of osteitis fibrosa but not of osteomalacia, but accumulation of aluminum in bone occurred during the study. We conclude that calcitriol delays and may prevent the development of osteitis fibrosa in patients receiving regular hemodialysis and may reasonably be prescribed routinely in hemodialysis patients without biochemical or radiological abnormality, unless there is a substantial prospect of early renal transplantation.
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Clinical Trial |
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Quezada Chalita CT, Blancas Galicìa L, Jannière L, García G, Moncada Velez M, Cienfuegos D, del Río B, Casanova JL, Boisson-Dupuis S, Bustamante J, Lugo Reyes SO. Salmonella vertebral osteitis and sepsis in a girl with interferon gamma pathway deficiency. J Investig Allergol Clin Immunol 2012; 22:289-291. [PMID: 22812200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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Case Reports |
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Forabosco A. [Preventive treatment with erythromycin in the extraction of impacted 3rd molars]. RIVISTA DI ODONTOSTOMATOLOGIA E IMPLANTOPROTESI 1983:19-21. [PMID: 6583609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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English Abstract |
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21
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CHUTE R, IRELAND EF. Dependent drainage via the perineum in retropubic prostatectomy. TRANSACTIONS OF THE AMERICAN ASSOCIATION OF GENITO-URINARY SURGEONS 1955; 47:140-6; discussion, 151-6. [PMID: 13281869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Benghuzzi H, Tucci M, Russell G, Ragab A, Graves M, Conflitti J. Targeted sustained delivery of tobramycin at the site of a femoral osteotomy. BIOMEDICAL SCIENCES INSTRUMENTATION 2006; 42:530-5. [PMID: 16817663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Complex fractures are difficult to manage because of the increased risk of secondary infection. Traditional treatments include debridment and local administration of antibiotics. Local antibiotic therapy is a safe technique resulting in high local concentration of antibiotics with minimal systemic levels. Local antibiotics effectively control infection in animal models. The length of implantation and the need for removal of the delivery vehicle places the patient at risk for additional surgical procedure as well as delays the fixation procedure. Development of a bioresorbable carrier that can deposit therapeutic concentrations of antibiotics locally without side-effects will provide positive outcomes for the patient. Tricalcium phosphate lysine (TCPL) ceramic capsules containing tobramycin were implanted at the site of a femoral osteotomy delivered therapeutic concentrations of the drug locally and reduced the incidence of infection compared to TCPL capsule which were uncharged by 50%. In addition, the ceramic material was osteoconductive and animals in TCPL + TOB and TCPL carrier alone showed evidence of osteoblast alkaline phosphatase activity for a period of 15 weeks. Neither the carrier nor the carrier containing antibiotics displayed untoward effects on body weight, vital organs and reproductive organs over a 15 week period. The results from this study demonstrated that TCPL can be used as an effective osteoconductive material capable of delivering therapeutic concentrations of antibiotics over 15 week period.
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Denischi A, Stănculescu D, Popescu M, Micu T, Dinulescu I. [Therapeutic management of fracture-induced osteitis]. REVISTA DE CHIRURGIE, ONCOLOGIE, RADIOLOGIE, O.R.L., OFTALMOLOGIE, STOMATOLOGIE. CHIRURGIE 1981; 30:199-205. [PMID: 6455698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Fractural osteitis is considered to be exclusively of external origin, being due either to accidental wounds, or to operatory wounds. The infection is usually either with a single strain of germs, or with a small number of strains, most frequently a staphylococcus strain with a necrototizing effect on the bone structure. The prophylaxis has a determinant role, and the authors stress the organisatory measures, as well as the medical attitudes that should prevail in the face of an open fracture. In the case of closed fractures that have been infected as a result of surgery the necessity for an "early reintervention" is stressed. Late postoperative osteitis may develop in a consolidated focus, and is called osteitis of the repaired bone. It may also develop as an osteoarthritis or, and this is more serious, as a suppurated pseudarthrosis. The therapeutic attitude depends on the condition, and may consist in the removal of the osteosynthesis material, removal of the sequestered bone tissue, a so-called: "mis-à-plat" of the cavity with muscular tissue and application of septopal pearls, or a two-stage spongious graft according to Papineau, under protection of the external fixation when the necessity arises.
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English Abstract |
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24
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Valdeavellano Pinot R. [Clinical evaluation of "Dental Preparation II" for the prevention of alveolar osteitis. Clinical study of 69 cases]. REVISTA GUATEMALTECA DE ESTOMATOLOGIA 1971; 1:9-13. [PMID: 5288143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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25
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Pennycook A, Makower R, O'Donnell AM. Puncture Wounds of the Foot: Can Infective Complications Be Avoided? Med Chir Trans 1994; 87:581-3. [PMID: 7966102 PMCID: PMC1294844 DOI: 10.1177/014107689408701004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The bacteriological flora of the foot and shoe was studied concurrently in 200 volunteers without foot injuries, and 80 patients with puncture wounds of the foot. Seven of 28 child patients developed clinical infections, three with Pseudomonas aeruginosa. Eleven of 52 adult patients also developed infections. No patients developed infection if oral antibiotics were given within the first 24 h after injury ( P>0.05). Oral antibiotic prophylaxis is recommended for puncture wounds of the foot.
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